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Al-Matary AM, Al Gashaa FAS. Comparison of different rapid screening tests and ELISA for HBV, HCV, and HIV among healthy blood donors and recipients at Jibla University Hospital Yemen. J Med Life 2022; 15:1403-1408. [PMID: 36567845 PMCID: PMC9762378 DOI: 10.25122/jml-2022-0051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/21/2022] [Indexed: 12/27/2022] Open
Abstract
Blood transfusion is associated with many risks, especially exposure to blood transfusion-transmitted infections considered one of the main causes of death worldwide, including hepatitis B (HBV) and C virus (HCV) and human immunodeficiency virus (HIV). The threat posed by blood-borne pathogens is disproportionately high, especially in developing countries, so there is a need for continuous monitoring of blood transfusions to prevent transmitting diseases. Rapid diagnostic immunochromatographic technique (ICT) methods are the most widely used methods in developing countries, although ELISA and molecular testing are considered more accurate worldwide. Therefore, the study aimed to compare the analytical sensitivity between rapid tests and the ELISA method for detecting HBV, HCV, and HIV infection among blood donors. Four hundred (400) blood donor samples were tested using the Rapid Test Kits (INTEC, SD, ABON, and CLUN), and the ELISA method was used as a confirmatory test. Out of 400 blood samples tested for viral infection, HBV, HCV, and HIV were detected in 8, 10, and 2 samples, respectively, using the ELISA technique. This study observed that the rate of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), in addition to determining the diagnostic accuracy rate and error rate for all rapid diagnostic kits in detecting HBV, HCV and HIV are less accurate and associated with more false negatives compared to the ELISA technique. This study showed a significant difference in sensitivity between ELISA and rapid diagnostic immunochromatographic technique (ICT) groups; therefore, rapid diagnosis is not suitable for testing the quality of infectious markers for blood donors.
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Affiliation(s)
| | - Fadhl Ahmed Saed Al Gashaa
- Department of Biology, Al Farabi University College, Baghdad, Iraq,Department of Medical Microbiology, College of Science, Ibb University, Ibb, Yemen,Corresponding Author: Fadhl Ahmed Saed Al Gashaa, Department of Biology, Al Farabi University College, Baghdad, Iraq. Department of Medical Microbiology, College of Science, Ibb University, Ibb, Yemen. E-mail:
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Xu JJ, Han MJ, Jiang YJ, Ding HB, Li X, Han XX, Lv F, Chen QF, Zhang ZN, Cui HL, Geng WQ, Zhang J, Wang Q, Kang J, Li XL, Sun H, Fu YJ, An MH, Hu QH, Chu ZX, Liu YJ, Shang H. Prevention and control of HIV/AIDS in China: lessons from the past three decades. Chin Med J (Engl) 2021; 134:2799-2809. [PMID: 34759226 PMCID: PMC8667973 DOI: 10.1097/cm9.0000000000001842] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.
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Affiliation(s)
- Jun-Jie Xu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Meng-Jie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yong-Jun Jiang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hai-Bo Ding
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiao-Xu Han
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Fan Lv
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Qing-Feng Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Zi-Ning Zhang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hua-Lu Cui
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Wen-Qing Geng
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Jing Zhang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Qi Wang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Jing Kang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Xiao-Lin Li
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hong Sun
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ya-Jing Fu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ming-Hui An
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Qing-Hai Hu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Zhen-Xing Chu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ying-Jie Liu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hong Shang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
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Mili FD, Teng Y, Shiraishi RW, Yu J, Bock N, Drammeh B, Watts DH, Benech I. New HIV infections from blood transfusions averted in 28 countries supported by PEPFAR blood safety programs, 2004-2015. Transfusion 2021; 61:851-861. [PMID: 33506960 DOI: 10.1111/trf.16256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/13/2020] [Accepted: 10/21/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND To quantify the impact of the US President's Emergency Plan for AIDS Relief (PEPFAR) on the risk of HIV transmission through infected blood donations in countries supported by PEPFAR blood safety programs. METHODS Data reported to the World Health Organization Global Database on Blood Safety were analyzed from 28 countries in sub-Saharan Africa (SSA), Asia, and the Caribbean during 2004-2015. We used the Goals model of Spectrum Spectrum System Software, version 5.53, to perform the modeling, assuming laboratory quality for HIV testing had 91.9% sensitivity and 97.7% specificity irrespective of testing method based on results of two external quality assurance and proficiency testing studies of transfusion screening for HIV in SSA blood centers. We calculated the number of new HIV infections from the number of transfusions and the prevalence of HIV infection acquired from blood transfusions with infected blood donations. We determined the impact of laboratory testing programs by estimating the number of new HIV infections averted since PEPFAR implementation. RESULTS Assuming that HIV testing would not be performed in any of these countries without PEPFAR funding, the number of new HIV infections acquired from blood transfusions averted by laboratory testing increased over time in all 28 countries. The total number of HIV infections averted was estimated at 229 278 out of 20 428 373 blood transfusions during 2004-2015. CONCLUSION Our mathematical modeling suggests a positive impact achieved over 12 years of PEPFAR support for blood safety. Standardized HIV testing of donated blood has reduced the risk of HIV transmission through blood transfusions in SSA, Asia, and the Caribbean.
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Affiliation(s)
- Fatima D Mili
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yu Teng
- Avenir Health, Glastonbury, Connecticut, USA
| | - Ray W Shiraishi
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Junping Yu
- World Health Organization, Geneva, Switzerland
| | - Naomi Bock
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bakary Drammeh
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - D Heather Watts
- Office of the U.S. Global AIDS Coordinator and Health Diplomacy, Washington, District of Columbia, USA
| | - Irene Benech
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Impact of Multiplex PCR in Reducing the Risk of Residual Transfusion-Transmitted Human Immunodeficiency and Hepatitis B and C Viruses in Burkina Faso. Mediterr J Hematol Infect Dis 2018; 10:e2018041. [PMID: 30002797 PMCID: PMC6039083 DOI: 10.4084/mjhid.2018.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/12/2018] [Indexed: 12/11/2022] Open
Abstract
Background and Objective The improved performance of serological tests has significantly reduced the risk of human immunodeficiency and hepatitis B and C viruses transmission by blood transfusion, but there is a persistence of residual risk. The objective of this study was to evaluate the impact of multiplex PCR in reducing the risk of residual transmission of these viruses in seronegative blood donors in Burkina Faso. Methods This cross-sectional study was conducted from March to September 2017. The serological tests were performed on sera using ARCHITECTSRi1000 (Abbot diagnosis, USA). Detection of viral nucleic acids was performed by multiplex PCR on mini-pools of seronegative plasma for HBV, HCV and HIV using SaCycler-96 Real Time PCR v.7.3 (Sacace Biotechnologies). Multiplex PCR-positive samples from these mini-pools were then individually tested by the same method. Results A total of 989 donors aged 17 to 65 were included in the present study. “Repeat donors” accounted for 44.79% (443/989). Seroprevalences for HIV, HBV, and HCV were 2.53% (25/989), 7.28% (72/989) and 2.73% (27/989), respectively. Of the 14 co-infections detected, HBV/HCV was the most common with 0.71% (7/989) of cases. Of 808 donations tested by multiplex PCR, 4.70% (38/808) were positive for HBV while no donation was positive for HIV or HCV. Conclusion Our study showed a high residual risk of HBV transmission through blood transfusion. Due to the high prevalence of blood-borne infections in Burkina Faso, we recommend the addition of multiplex PCR to serologic tests for optimal blood donation screening.
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Friedman EE, Dean HD, Duffus WA. Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Public Health Rep 2018; 133:392-412. [PMID: 29874147 DOI: 10.1177/0033354918774788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Social determinants of health (SDHs) are the complex, structural, and societal factors that are responsible for most health inequities. Since 2003, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) has researched how SDHs place communities at risk for communicable diseases and poor adolescent health. We described the frequency and types of SDHs discussed in articles authored by NCHHSTP. METHODS We used the MEDLINE/PubMed search engine to systematically review the frequency and type of SDHs that appeared in peer-reviewed publications available in PubMed from January 1, 2009, through December 31, 2014, with a NCHHSTP affiliation. We chose search terms to identify articles with a focus on the following SDH categories: income and employment, housing and homelessness, education and schooling, stigma or discrimination, social or community context, health and health care, and neighborhood or built environment. We classified articles based on the depth of topic coverage as "substantial" (ie, one of ≤3 foci of the article) or "minimal" (ie, one of ≥4 foci of the article). RESULTS Of 862 articles authored by NCHHSTP, 366 (42%) addressed the SDH factors of interest. Some articles addressed >1 SDH factor (366 articles appeared 568 times across the 7 categories examined), and we examined them for each category that they addressed. Most articles that addressed SDHs (449/568 articles; 79%) had a minimal SDH focus. SDH categories that were most represented in the literature were health and health care (190/568 articles; 33%) and education and schooling (118/568 articles; 21%). CONCLUSIONS This assessment serves as a baseline measurement of inclusion of SDH topics from NCHHSTP authors in the literature and creates a methodology that can be used in future assessments of this topic.
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Affiliation(s)
- Eleanor E Friedman
- 1 Association of Schools and Programs of Public Health/CDC Public Health Fellowship Program, Atlanta, GA, USA.,2 Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.,3 Chicago Center for HIV Elimination and University of Chicago Department of Medicine, Chicago, IL, USA
| | - Hazel D Dean
- 4 Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wayne A Duffus
- 2 Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ly KN, Kim AA, Drobeniuc J, Kodani M, Montgomery JM, Fields BS, Teshale EH. The Prevalence of Hepatitis C Virus Antibody in HIV-Negative Persons in Kenya, 2007. Am J Trop Med Hyg 2018; 98:1876-1879. [PMID: 29692313 DOI: 10.4269/ajtmh.17-0830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The prevalence of hepatitis C virus (HCV) infection in the Kenyan population has not been previously determined. We estimated the Kenyan HCV prevalence in HIV-negative persons aged 15-64 years. This is a retrospective cross-sectional study using data from the 2007 Kenya AIDS Indicator Survey-a nationally representative sample of 15,853 persons aged 15-64 years who completed a health interview and provided a blood specimen. Of the 1,091 randomly selected participants, 50 tested positive for HCV antibody using the automated chemiluminescence immunoassay, corresponding to a weighted HCV antibody positivity rate of 4.4% (95% confidence interval: 3.3-5.9%) or 848,000 (range: 634,000-1,100,000) persons. Hepatitis C virus RNA, a marker for current infection, was not detected in any of the tested antibody-positive specimens. The high HCV antibody prevalence together with no current infection suggests that some HCV antibody serologic testing in Kenya may result in false positives whereas others may be because of spontaneous viral clearance.
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Affiliation(s)
- Kathleen N Ly
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrea A Kim
- Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jan Drobeniuc
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maja Kodani
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joel M Montgomery
- Division of Global Health Protection, Center for Global Health, U.S. Centers for Disease Control and Prevention-Kenya, Atlanta, Georgia
| | - Barry S Fields
- Division of Global Health Protection, Center for Global Health, U.S. Centers for Disease Control and Prevention-Kenya, Atlanta, Georgia
| | - Eyasu H Teshale
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
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Onyango CG, Ogonda L, Guyah B, Okoth P, Shiluli C, Humwa F, Opollo V. Seroprevalence and determinants of transfusion transmissible infections among voluntary blood donors in Homabay, Kisumu and Siaya counties in western Kenya. BMC Res Notes 2018. [PMID: 29530086 PMCID: PMC5848540 DOI: 10.1186/s13104-018-3276-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective Since the implementation of a series of blood donation safety improvements in Kenya, information about seroprevalence and determinants of transfusion transmissible infections among voluntary blood donors especially in high HIV burden regions of Homabay, Kisumu and Siaya counties remain scanty. A cross-sectional study examining HIV, syphilis, hepatitis B and C virus sero-markers and associated determinants was conducted among voluntary blood donors. Their demographic characteristics and previous risk exposure were recorded in a pre-donation questionnaire, while blood samples collected were screened for hepatitis B, hepatitis C, human immunodeficiency viruses by ELISA and RPR (syphilis), then confirmed using CMIA. Results Overall TTIs seroprevalence was 114 (9.4%), distributed among HIV, HBV, HCV and syphilis at 14 (1.15%), 42 (3.46%), 39 (3.21%) and 19 (1.56%), respectively, with co-infections of 3 (0.25%). There were no significant differences in proportions distributions among demographic variables. However, high risk sex was significantly associated with higher odds of HBV infections [> 1 partner vs. 0–1 partner; odd ratio (OR) 2.60; 95% confidence interval (CI) 1.098–6.86; p = 0.046]. In conclusion, a substantial percentage of blood donors still harbor transfusion transmissible infections despite recent safety improvements with greater majority cases caused by HBV infections arising from previous exposure to high risk sex. Electronic supplementary material The online version of this article (10.1186/s13104-018-3276-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Calleb George Onyango
- Department of Biomedical Science and Technology, Maseno University, Maseno, Kenya. .,Regional Blood Transfusion Center, Kisumu, Kenya. .,, Kisumu-Kakamega Road, P.O Box 849, Kisumu, Code 40100, Kenya.
| | - Lilian Ogonda
- Department of Biomedical Science and Technology, Maseno University, Maseno, Kenya
| | - Bernard Guyah
- Department of Biomedical Science and Technology, Maseno University, Maseno, Kenya
| | - Peter Okoth
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya
| | - Clement Shiluli
- Department of Biomedical Science and Technology, Maseno University, Maseno, Kenya
| | - Felix Humwa
- Center for Disease Control and Prevention, Kisumu, Kenya
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Drammeh B, De A, Bock N, Pathak S, Juma A, Kutaga R, Mahmoud M, Haule D, Sembucha S, Chang K, Nkya E, Kuehnert M, Marfin AA. Estimating Tanzania's National Met and Unmet Blood Demand From a Survey of a Representative Sample of Hospitals. Transfus Med Rev 2018; 32:36-42. [PMID: 28843515 PMCID: PMC5831253 DOI: 10.1016/j.tmrv.2017.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 06/23/2017] [Accepted: 07/11/2017] [Indexed: 11/16/2022]
Abstract
Estimating blood demand to determine collection goals challenges many low-income countries. We sampled Tanzanian hospitals to estimate national blood demand. A representative sample based on probability proportional to size sampling of 42 of 273 (15%) Tanzanian transfusing hospitals was selected. Blood bank registers, patient medical records, and blood component disposition records were reviewed prospectively from June to September 2013 to determine the number of components requested and the number and proportion issued, not issued due to nonavailability, and not issued for other reasons. Data were estimated for an annual national estimate. Of an estimated 278 371 components requested in 2013, 6648 (2.4%) were not issued due to nonavailability, 34 591 (12.4%) were not issued for other reasons, and 244 535 (87.8%) were issued. Of these 278 371 components, 86 753 (31.2%) were requested by adult medical, 74 499 (26.8%) by pediatric medical, and 57 312 (20.6%) by obstetric units. In these 3 units, the proportion of units not issued due to nonavailability was 1.8%. Private (4.1%) and large (6%) hospitals had the largest proportion of units not issued because of nonavailability. Of 244 535 issued components, 91 690 (37.5%) were collected, tested, and issued from blood banks that are not part of the Tanzania National Blood Transfusion Services (TNBTS). Nearly 98% of blood component demand was met. However, a large portion of the blood supply for the hospitals came from non-TNBTS blood banks. TNBTS could increase availability of safe blood through assuring the quality of donor selection and donation testing at non-TNBTS blood banks.
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Affiliation(s)
- Bakary Drammeh
- HIV Prevention Branch, Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA.
| | - Anindya De
- Epidemiology and Strategic Information Branch, Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA
| | - Naomi Bock
- HIV Prevention Branch, Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Abdu Juma
- Tanzania National Blood Transfusion Services, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
| | - Regina Kutaga
- US Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Mwanakheir Mahmoud
- Zanzibar National Blood Transfusion Services, Ministry of Health Zanzibar, Zanzibar
| | - Dunstan Haule
- Tanzania National Blood Transfusion Services, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
| | - Senga Sembucha
- Field Epidemiology and Laboratory Training Program, US Centers for Disease Control and Prevention, Dar es Salaam, Tanzania
| | - Karen Chang
- Allan Rosenfield Global Health Fellow, American Schools of Public Health/Centers for Disease Control and Prevention, Atlanta, GA
| | - Efespa Nkya
- Tanzania National Blood Transfusion Services, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
| | - Matthew Kuehnert
- Office of Blood, Organ, and Other Tissue Safety, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Anthony A Marfin
- HIV Prevention Branch, Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA; PATH, Seattle, WA
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Roberts DJ, Field S, Delaney M, Bates I. Problems and Approaches for Blood Transfusion in the Developing Countries. Hematol Oncol Clin North Am 2016; 30:477-95. [DOI: 10.1016/j.hoc.2015.11.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Naidu NK, Bharucha ZS, Sonawane V, Ahmed I. Nucleic acid testing: Is it the only answer for safe Blood in India? Asian J Transfus Sci 2016; 10:79-83. [PMID: 27011677 PMCID: PMC4782501 DOI: 10.4103/0973-6247.175423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: With the implementation of NAT in countries around the world, there is a growing pressure on the transfusion services in India to adopt NAT testing. India has about 2545 licensed Blood Centres. The Transfusion Services in India are fragmented, poorly regulated and the quality standards are poorly implemented. Blood Centres are still dependent on replacement/family donors and in most places laboratory testing for Transfusion transmitted infections is not quality assured, laboratory equipment are not calibrated and maintained, and validation of results is not carried out. Against the current scenario introducing NAT for screening of blood donors in India would pose a challenge. Aim: To study the prudence of universal NAT testing in India. Materials and Methods: A retrospective study of 5 years from 2008-2012 was undertaken to study the true reactivity of donors using WHO strategy II and III and therefore the true seroprevalence of TTI infections in the donor populations. Results: The true reactivity of the donors was much less as compared to the initially reactive donors due to the use of a well designed testing algorithm. In addition having a total voluntary blood collection along with good pre-donation counseling program also reduces the transmission of infections. Conclusions: What India essentially needs to do is religiously implement the strategies outlined in the WHO Aide-memoire. The blood should be collected only from voluntary non remunerative and repeat donors, there should be stringent donor selection with pre-donation counseling instituted. Strict implementation of quality management system, development of well defined testing startegies and strong haemovigilance system could take us a step in the right direction.
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Affiliation(s)
- N K Naidu
- Medical Director, Indian Red Cross Society, Bombay City Branch Blood Centre, Mumbai, India
| | - Z S Bharucha
- Chairperson, Indian Red Cross Society, Bombay City Branch Blood Centre, Mumbai, India
| | - Vandana Sonawane
- Technical Supervisor, Indian Red Cross Society, Bombay City Branch Blood Centre, Mumbai, India
| | - Imran Ahmed
- Technologist, Indian Red Cross Society, Bombay City Branch Blood Centre, Mumbai, India
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Chevalier MS, Kuehnert M, Basavaraju SV, Bjork A, Pitman JP. Progress Toward Strengthening National Blood Transfusion Services - 14 Countries, 2011-2014. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2016; 65:115-9. [PMID: 26866413 DOI: 10.15585/mmwr.mm6505a4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Blood transfusion is a life-saving medical intervention; however, challenges to the recruitment of voluntary, unpaid or otherwise nonremunerated whole blood donors and insufficient funding of national blood services and programs have created obstacles to collecting adequate supplies of safe blood in developing countries (1). Since 2004, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has provided approximately $437 million in bilateral financial support to strengthen national blood transfusion services in 14 countries in sub-Saharan Africa and the Caribbean* that have high prevalence rates of human immunodeficiency virus (HIV) infections. CDC analyzed routinely collected surveillance data on annual blood collections and HIV prevalence among donated blood units for 2011-2014. This report updates previous CDC reports (2,3) on progress made by these 14 PEPFAR-supported countries in blood safety, summarizes challenges facing countries as they strive to meet World Health Organization (WHO) targets, and documents progress toward achieving the WHO target of 100% voluntary, nonremunerated blood donors by 2020 (4). During 2011-2014, overall blood collections among the 14 countries increased by 19%; countries with 100% voluntary, nonremunerated blood donations remained stable at eight, and, despite high national HIV prevalence rates, 12 of 14 countries reported an overall decrease in donated blood units that tested positive for HIV. Achieving safe and adequate national blood supplies remains a public health priority for WHO and countries worldwide. Continued success in improving blood safety and achieving WHO targets for blood quality and adequacy will depend on national government commitments to national blood transfusion services or blood programs through increased public financing and diversified funding mechanisms for transfusion-related activities.
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12
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Dogbe EE, Arthur F. Diagnostic accuracy of blood centers in the screening of blood donors for viral markers. Pan Afr Med J 2015; 20:119. [PMID: 26090067 PMCID: PMC4458317 DOI: 10.11604/pamj.2015.20.119.5263] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 11/25/2014] [Indexed: 11/11/2022] Open
Abstract
Introduction Blood transfusion still remains a life saving intervention in almost all healthcare facilities worldwide. Screening of blood donors/blood units is done in almost every blood bank facility before the blood units/blood components are transfused to prevent transfusion-transmissible infections. The kind of testing kits or the methods used by a facility and the technical expertise of the personnel greatly affects the screening results of a facility. This study was aimed at evaluating the diagnostic accuracy of five hospital-based blood bank testing facilities (Komfo Anokye Teaching Hospital KNUST, Kwame Nkrumah University of Science and Technology, Agogo, Bekwai and Sunyani) that used rapid immunochromatograhic assays (RIA) in screening blood donors/blood units in Ghana. Methods Blood samples (300) from the five testing facilities and their screening results for hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (HCV) and human immunodeficiency virus (HIV) using RIAs were obtained. All the samples were then analysed for the three viral markers using 3rd generational enzyme linked immunosorbent assay (ELISA) kit as the gold standard. Results The mean false positive for HBsAg was 2.2% with Bekwai testing facility having the highest of 4.4%. For HCV, the mean false positive was 2.8% with Agogo and Bekwai testing facilities having the highest of 8.7% respectively. For HIV screening, the mean false positive was 11.1% with Bekwai testing facility having the highest of 28.0%. The mean false negative for the facilities were 3.0% for HBV, 75.0% for HCV and 0.0% for HIV with KATH having the highest of 6.3% for HBV, Bekwai having the highest of 100% for HCV and no facility showing false negative for HIV. Mean sensitivity of the screening procedure for the facilities was 97.0%, 25.0% and 100.0% whilst the mean specificity was 97.8%, 97.2% and 88.9% for HBV, HCV and HIV respectively. Statistical comparison among the testing facilities showed no significant differences among the various testing centres for HBV screening; however, significant differences were obtained for HCV and HIV screening. Conclusion This study has shown that there is no standardised screening procedure for blood bank testing facilities in the country. There is therefore an urgent need for an internal and external control body to oversee screening procedures in blood banks across the country.
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Affiliation(s)
- Elliot Eli Dogbe
- Transfusion Medicine Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Fareed Arthur
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Pitman JP, Wilkinson R, Basavaraju SV, von Finckenstein B, Sibinga CS, Marfin AA, Postma MJ, Mataranyika M, Tobias J, Lowrance DW. Investments in blood safety improve the availability of blood to underserved areas in a sub-Saharan African country. ACTA ACUST UNITED AC 2014; 9:325-333. [PMID: 26478742 DOI: 10.1111/voxs.12107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Since 2004, several African countries, including Namibia, have received assistance from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). Gains have been documented in the safety and number of collected units in these countries, but the distribution of blood has not been described. MATERIALS AND METHODS Nine years of data on blood requests and issues from Namibia were stratified by region to describe temporal and spatial changes in the number and type of blood components issued to Namibian healthcare facilities nationally. RESULTS Between 2004 and 2007 (early years of PEPFAR support) and 2008-2011 (peak years of PEPFAR support), the average number of red cell units issued annually increased by 23.5% in seven densely populated but less-developed regions in northern Namibia; by 30% in two regions with urban centres; and by 35.1% in four sparsely populated rural regions. CONCLUSION Investments in blood safety and a policy decision to emphasize distribution of blood to underserved regions improved blood availability in remote rural areas and increased the proportion of units distributed as components. However, disparities persist in the distribution of blood between Namibia's urban and rural regions.
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Affiliation(s)
- J P Pitman
- Center for Global Health, Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - R Wilkinson
- The Blood Transfusion Service of Namibia, Windhoek, Namibia
| | - S V Basavaraju
- Center for Global Health, Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - A A Marfin
- Center for Global Health, Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M J Postma
- Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, Netherlands ; Institute of Science in Healthy Aging & health caRE (SHARE), University Medical Center Groningen (UMCG), Groningen, Netherlands
| | - M Mataranyika
- Directorate for Clinical Support Services, Ministry of Health and Social Services, Windhoek, Namibia
| | - J Tobias
- Center for Global Health, Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - D W Lowrance
- Center for Global Health, Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Pruett CR, Vermeulen M, Zacharias P, Ingram C, Tayou Tagny C, Bloch EM. The use of rapid diagnostic tests for transfusion infectious screening in Africa: a literature review. Transfus Med Rev 2014; 29:35-44. [PMID: 25447555 DOI: 10.1016/j.tmrv.2014.09.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/09/2014] [Accepted: 09/16/2014] [Indexed: 12/22/2022]
Abstract
Infectious risk associated with blood transfusion remains a major public health challenge in Africa, where prevalence rates of the major transfusion-transmissible infections (ie, hepatitis B, hepatitis C, human immunodeficiency virus, and syphilis) are among the highest in the world. Resource-limited blood services often operate with minimal predonation screening safeguards, prompting exclusive reliance on laboratory testing to mitigate infectious risk. Transfusion screening with rapid diagnostic tests (RDTs) has been adopted in areas that lack the capacity to support the routine use of more sophisticated technologies. However, uncertainty surrounding the performance of some RDTs in the field has spurred debate regarding their application to blood donation screening. Our review of the literature identified 17 studies that evaluated RDTs for the infectious screening of blood donors in Africa. The review highlights the variable performance of available RDTs and the importance of their use in a quality-assured manner. Deficiencies in performance observed with some RDTs underscore the need to validate test kits prior to use under field conditions with locally acquired samples. Suboptimal sensitivities of some available tests, specifically hepatitis B virus rapid assays, question their suitability in single-test algorithms, particularly in high-prevalence regions. Although RDTs have limitations, many of which can be addressed through improved training and quality systems, they are frequently the only viable option for infectious screening in resource-poor African countries. Therefore, additional studies and specific guidelines regarding the use of RDTs in the context of blood safety are needed.
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Affiliation(s)
| | - Marion Vermeulen
- South African National Blood Service, Johannesburg, South Africa
| | | | - Charlotte Ingram
- South African National Blood Service, Johannesburg, South Africa
| | | | - Evan M Bloch
- Blood Systems Research Institute, San Francisco, CA; University of California San Francisco, San Francisco, CA
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Osaro E, Mohammed N, Zama I, Yakubu A, Dorcas I, Festus A, Kwaifa I, Sani I. Prevalence of p24 antigen among a cohort of HIV antibody negative blood donors in Sokoto, North Western Nigeria--the question of safety of blood transfusion in Nigeria. Pan Afr Med J 2014; 18:174. [PMID: 25419301 PMCID: PMC4236925 DOI: 10.11604/pamj.2014.18.174.3449] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 03/04/2014] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Blood transfusions remain a substantial source of HIV in SSA particularly among children and pregnant women. AIMS AND OBJECTIVES This aim of this retrospective study was to investigate the prevalence of p24 antigen among HIV antibody seronegative blood donors in Sokoto, North West Nigeria. METHODS A total of 15,061 HIV antibody negative blood donors with mean age and age range (29.2 ± 8.18 and 18-50 years) were screened for p24 antigen between January 2010 to July 2013 using the Diapro Diagnostic immunoassay kit for P24 antigen (King Hawk Pharmaceuticals Beijing China). RESULTS The overall prevalence of p24 antigen among the HIV antibody negative donors sample was 5.84%. The yearly prevalence was 9.79, 8.12, 2.7 and 2.84% respectively in 2010, 2011, 2012 and 2013. Of the total number of blood donor tested, 14,968 (99.38%) were males while 93 (0.62%) were females. The prevalence of P24 antigen was significantly higher among male blood donors 873 (5.8%) compared to females 7(0.05%), (p= 0.001). P24 positivity was significantly higher among blood group O blood donors compared to A, B and AB donors (494 (3.29%) compared to 184 (1.89%), 196 (1.30%) and 6 (0.04%)) respectively, p = 0.001). The prevalence of P24 antigen was significantly higher among Rhesus positive blood donors compared to Rhesus negative (807 (5.36%) versus 73 (0.48%), p =0.001). CONCLUSION Blood transfusion in Nigeria is associated with increased risk of HIV transmission. There is the urgent need to optimize the screening of blood donors in Nigeria by the inclusion of p24 antigen testing into the blood donor screening menu. The Nigerian government urgently need to adopt the WHO blood safety strategies to reduce the risk of transmission of HIV through blood transfusion.
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Affiliation(s)
- Erhabor Osaro
- Department of Haematology and Transfusion Medicine, Faculty of Medical Laboratory Science Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Ndakotsu Mohammed
- Department of Haematology and Blood Transfusion Usmanu Danfodio University Teaching Hospital Sokoto
| | - Isaac Zama
- Department of Haematology and Transfusion Medicine, Faculty of Medical Laboratory Science Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Abdulrahaman Yakubu
- Department of Haematology and Transfusion Medicine, Faculty of Medical Laboratory Science Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Ikhuenbor Dorcas
- Department of Haematology and Blood Transfusion Usmanu Danfodio University Teaching Hospital Sokoto
| | - Aghedo Festus
- Department of Haematology and Blood Transfusion Usmanu Danfodio University Teaching Hospital Sokoto
| | - Ibrahim Kwaifa
- Department of Haematology and Blood Transfusion Usmanu Danfodio University Teaching Hospital Sokoto
| | - Ibrahim Sani
- Department of Haematology and Blood Transfusion Usmanu Danfodio University Teaching Hospital Sokoto
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Estimation of the prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12:352-61. [PMID: 24333079 DOI: 10.2450/2013.0143-13] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 08/01/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Acute transfusion reactions are probably common in sub-Saharan Africa, but transfusion reaction surveillance systems have not been widely established. In 2008, the Blood Transfusion Service of Namibia implemented a national acute transfusion reaction surveillance system, but substantial under-reporting was suspected. We estimated the actual prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia. METHODS The percentage of transfusion events resulting in a reported acute transfusion reaction was calculated. Actual percentage and rates of acute transfusion reactions per 1,000 transfused units were estimated by reviewing patients' records from six hospitals, which transfuse >99% of all blood in Windhoek. Patients' records for 1,162 transfusion events occurring between 1(st) January - 31(st) December 2011 were randomly selected. Clinical and demographic information were abstracted and Centers for Disease Control and Prevention National Healthcare Safety Network criteria were applied to categorize acute transfusion reactions. RESULTS From January 1 - December 31, 2011, there were 3,697 transfusion events (involving 10,338 blood units) in the selected hospitals. Eight (0.2%) acute transfusion reactions were reported to the surveillance system. Of the 1,162 transfusion events selected, medical records for 785 transfusion events were analysed, and 28 acute transfusion reactions were detected, of which only one had also been reported to the surveillance system. An estimated 3.4% (95% confidence interval [CI]: 2.3-4.4) of transfusion events in Windhoek resulted in an acute transfusion reaction, with an estimated rate of 11.5 (95% CI: 7.6-14.5) acute transfusion reactions per 1,000 transfused units. CONCLUSION The estimated actual rate of acute transfusion reactions is higher than the rate reported to the national haemovigilance system. Improved surveillance and interventions to reduce transfusion-related morbidity and mortality are required in Namibia.
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Affiliation(s)
- Neelam Dhingra
- Blood Transfusion Safety (on behalf of WHO, Health Systems and Innovation Cluster), World Health Organization, Geneva, 1211, Switzerland
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Process improvement by eliminating mixing of whole blood units after an overnight hold prior to component production using the buffy coat method. JOURNAL OF BLOOD TRANSFUSION 2013; 2013:154838. [PMID: 24066260 PMCID: PMC3771126 DOI: 10.1155/2013/154838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 05/16/2013] [Accepted: 05/16/2013] [Indexed: 11/18/2022]
Abstract
The elimination of a thorough manual mixing of whole blood (WB) which takes place following the overnight hold, but before the first centrifugation step, during buffy coat component production at Canadian Blood Services (CBS) was investigated. WB was pooled after donation and split. Pairs of platelet, red blood cell (RBC), and plasma components were produced, with half using the standard method and half using a method in which the mixing step was eliminated. Quality assessments included yield, pH, CD62P expression and morphology for platelets, hemoglobin, hematocrit, hemolysis, and supernatant K+ for RBCs, and volume and factor VIII activity levels for plasma. All components, produced using either method, met CBS quality control criteria. There were no significant differences in platelet yield between components produced with and without mixing. A significant difference was seen for RBC hemolysis at expiry (P = 0.03), but for both groups, levels met quality control requirements. Noninferiority of components produced without mixing was confirmed for all parameters. Manual mixing is laborious and has a risk of repetitive strain for production staff and its significance is unclear. Elimination of this step will improve process efficiencies without compromising quality.
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Bugge HF, Karlsen NCT, Oydna E, Rake MM, Wexels N, Bendabenda J, Roald B, Heier HE, Chisuwo L, Jourdan PM. A study of blood transfusion services at a district hospital in Malawi. Vox Sang 2012; 104:37-45. [DOI: 10.1111/j.1423-0410.2012.01628.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Okonji JA, Basavaraju SV, Mwangi J, Shiraishi RW, Odera M, Ouma K, Pitman JP, Marum LH, Ou CY, Zeh C. Comparison of HIV-1 detection in plasma specimens and dried blood spots using the Roche COBAS Ampliscreen HIV-1 test in Kisumu, Kenya. J Virol Methods 2011; 179:21-5. [PMID: 21777620 DOI: 10.1016/j.jviromet.2011.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 06/30/2011] [Accepted: 07/04/2011] [Indexed: 11/18/2022]
Abstract
The World Health Organization recommends screening donor blood for HIV in centralized laboratories. This recommendation contributes to quality, but presents specimen transport challenges for resource-limited settings which may be relieved by using dried blood spots (DBS). In sub-Saharan Africa, most countries screen donor blood with serologic assays only. Interest in window period reduction has led blood services to consider adding HIV nucleic acid testing (NAT). The U.S. Food and Drug Administration (FDA) mandates that HIV-1 NAT blood screening assays have a 95% detection limit at or below 100 copies/ml and 5000 copies/ml for pooled and individual donations, respectively. The Roche COBAS Ampliscreen HIV-1 test, version 1.5, used for screening whole blood or components for transfusion, has not been tested with DBS. We compared COBAS Ampliscreen HIV-1 RNA detection limits in DBS and plasma. An AIDS Clinical Trials Group, Viral Quality Assurance laboratory HIV-1 standard with a known viral load was used to create paired plasma and DBS standard nine member dilution series. Each was tested in 24 replicates with the COBAS Ampliscreen. A probit analysis was conducted to calculate 95% detection limits for plasma and DBS, which were 23.8 copies/ml (95% CI 15.1-51.0) for plasma and 106.7 copies/ml (95% CI 73.8-207.9) for DBS. The COBAS Ampliscreen detection threshold with DBS suggests acceptability for individual donations, but optimization may be required for pooled specimens.
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Affiliation(s)
- Jully A Okonji
- Centre for Biomedical Research and Technology, Kenya Medical Research Institute (KEMRI), Off Kisumu-Busia Road, P.O. Box 1578-40100, Kisumu, Kenya.
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Vermeulen M, Lelie N, Reddy R. Recent insights in testing for transfusion transmissible viral infections. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1751-2824.2011.01492.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Blood transfusion safety in sub-Saharan Africa (SSA) is marred by the high prevalence of infectious agents, chronic blood shortage and lack of resources. However, considerable pressure is applied by richer countries and international transfusion bodies to establish voluntary, non-remunerated blood donors (VNRD) as the only source of blood, excluding the traditional family/replacement donors on the grounds of a higher level of safety. Such a policy increases the cost of a unit of blood by two to fivefold and exacerbates the pre-existing blood shortage. This review provides compelling evidence that first-time VNRD are no safer than family/replacement donors and that only repeat donation provides improved blood safety. In order to limit blood shortage and maintain affordability of the blood supply in SSA, both types of donors should be accepted and both should be encouraged to donate regularly.
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Affiliation(s)
- Jean-Pierre Allain
- Division of Transfusion Medicine, Department of Haematology, University of Cambridge, Cambridge, UK
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